Simó C, García-Cañas V
Molecular Nutrition and Metabolism, Institute of Food Science Research (CIAL, CSIC-UAM), c/Nicolás Cabrera 9, 28049 Madrid, Spain.
Food Funct. 2020 Aug 1;11(8):6745-6776. doi: 10.1039/d0fo01237h. Epub 2020 Jul 20.
There is a growing body of clinical evidence that supports a strong association between elevated circulating trimethylamine N-oxide (TMAO) levels with increased risk of developing adverse cardiovascular outcomes such as atherosclerosis and thrombosis. TMAO is synthesized through a meta-organismal stepwise process that involves (i) the microbial production of TMA in the gut from dietary precursors and (ii) its subsequent oxidation to TMAO by flavin-containing monooxygenases in the liver. Choline, l-carnitine, betaine, and other TMA-containing compounds are the major dietary precursors of TMA. TMAO can also be absorbed directly from the gastrointestinal tract after the intake of TMAO-rich foods such as fish and shellfish. Thus, diet is an important factor as it provides the nutritional precursors to eventually produce TMAO. A number of studies have attempted to associate circulating TMAO levels with the consumption of diets rich in these foods. On the other hand, there is growing interest for the development of novel food ingredients that reduce either the TMAO-induced damage or the endogenous TMAO levels through the interference with microbiota and host metabolic processes involved in TMAO pathway. Such novel functional food ingredients would offer great opportunities to control circulating TMAO levels or its effects, and potentially contribute to decrease cardiovascular risk. In this review we summarize and discuss current data regarding the effects of TMA precursors-enriched foods or diets on circulating TMAO levels, and recent findings regarding the circulating TMAO-lowering effects of specific foods, food constituents and phytochemicals found in herbs, individually or in extracts, and their potential beneficial effect for cardiovascular health.
越来越多的临床证据支持循环中的氧化三甲胺（TMAO）水平升高与发生动脉粥样硬化和血栓形成等不良心血管结局风险增加之间存在密切关联。TMAO通过一个多生物体的逐步过程合成，该过程包括：（i）肠道微生物从膳食前体产生TMA，以及（ii）其随后在肝脏中被含黄素单加氧酶氧化为TMAO。胆碱、左旋肉碱、甜菜碱和其他含TMA的化合物是TMA的主要膳食前体。摄入富含TMAO的食物（如鱼类和贝类）后，TMAO也可直接从胃肠道吸收。因此，饮食是一个重要因素，因为它提供了最终产生TMAO的营养前体。许多研究试图将循环中的TMAO水平与富含这些食物的饮食摄入联系起来。另一方面，人们越来越关注开发新型食品成分，这些成分通过干扰参与TMAO途径的微生物群和宿主代谢过程来减少TMAO诱导的损伤或内源性TMAO水平。这种新型功能性食品成分将为控制循环中的TMAO水平或其影响提供巨大机会，并可能有助于降低心血管风险。在这篇综述中，我们总结并讨论了关于富含TMA前体的食物或饮食对循环TMAO水平影响的现有数据，以及关于特定食物、食物成分和草药中发现的植物化学物质（单独或提取物形式）降低循环TMAO水平的最新发现，以及它们对心血管健康的潜在有益作用。
